CASE OF THE WEEK
When examining this 7 year old‘s mouth, you see what appears to be an unusual number of teeth erupting in the lower jaw as shown in this picture. Should you be concerned?
Answer: No, there is no reason for concern. The permanent lower central incisors commonly erupt behind (or lingual to) the primary teeth. You can differentiate the permanent teeth from the primary teeth because the erupting permanent teeth are larger and have mamelons—bumps along the top of the tooth, which gradually wear down over time.
You can counsel this patient and family that, in all likelihood, the primary lower central incisors will soon become loose and fall out. The tongue will gradually push the permanent lower central incisors into occlusion.
When to act? After 6 months like this and the primary lower central incisors are still not loose, the child should be seen by a dentist for further evaluation.
ORAL HEALTH IN YOUR OFFICE
COMMON DENTAL PROBLEMS AND EMERGENCIES
Ankyloglossia and Sublingual Frenotomy
FLUORIDE/ FLUORIDE VARNISH/EDUCATION AND BILLING
CDC Fact Sheet: Community Water Fluoridation (with references)
CDC Infographic: How Fluoride Works
REFERRAL SITES/RESOURCES/MISC ARTICLES
Dentistlink Dentist Referrals (Washington State)
Arcora Foundation – downloadable oral health education resources
Free oral health materials for families (available in several languages)